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Many of the issues facing our country are extraordinarily complex and nuanced. In order to understand these policy issues and the various perspectives around them, elected leaders, government staff, the public, industry, and nonprofits must first have an objective basic knowledge that is rooted in fact. Center Forward’s Basics series presents complicated issues in a non-partisan and easy-to-understand manner.

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Tariffs and Trade Rules: Considerations in Digital Commerce

Trade

Digital trade shapes our everyday life and is a growing portion of the global economy. The U.S. and countries around the world are seeking to balance promoting innovation and market access with concerns over revenue collection and fair competition.

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Competitive Bidding Under Medicare for Durable Medical Equipment

Health Care

The Centers for Medicare and Medicaid Services (CMS) operates a competitive bidding program to pay for certain categories of durable medical equipment (DME)  for original Medicare beneficiaries, ranging from mobility devices like wheelchairs, diabetes testing supplies like blood glucose monitors, and other supplies like back and knee braces for patients living in Competitive Bidding Areas (CBAs). When CMS decides a category of equipment should be eligible for competitive bidding for DME, they go through a process of soliciting bids and selecting from eligible proposals to find the lowest-cost supplier that still meets volume and quality requirements. The core rationale behind competitive bidding for DME  is threefold: cost savings, reduced fraud and waste, and improved oversight. Because fewer approved suppliers operate in each contract area, CMS can more easily monitor compliance and quality, control costs, and identify potential issues. In this Basic, we examine the competitive bidding framework, from how CMS solicits bids and awards contracts to the quality and financial standards suppliers must meet.

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Alternative Investments in 401(k)s

Financial Services

Retirement security remains a significant concern for many Americans. Gallup found that 69% of non-retired Americans are very or moderately worried about not having enough money for retirement, and an Allianz survey found that 64% of Americans are more concerned about running out of money than about death. As policymakers look to alleviate these fears, some have pointed to possible changes in how retirement plans operate as a solution. Before the 1980s, most Americans were covered by a pension plan at work. Over time, for a variety of reasons, employers shifted to offering a 401(k) plan instead, and now most U.S. citizens use 401(k)s as their primary tool to save for retirement. One difference is the range of assets that each plan can invest in.

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Medicare Advantage: How it Works, How it’s Financed, and What’s Next?

Health Care

Medicare Advantage, also known as Medicare Part C, is a core part of the Medicare program in which the federal government partners with private health insurance companies to provide benefits to those eligible for Medicare. In recent years, enrollment in the program has increased significantly, with over half of Medicare beneficiaries (about 54%) choosing Medicare Advantage over “traditional” Medicare in 2025. 

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Treasuries and How the U.S. Government is Funded

Financial Services

The U.S. government is a large federal bureaucracy that needs money to run its operations. To this end, the government funds itself in two ways. First is the tax revenue it collects. However, the government often does not collect enough in taxes to fund itself. Additionally, federal inflows and outflows do not coincide throughout the year, leading to budgetary shortfalls. As a result, the Department of the Treasury (the Treasury) issues bonds of varying maturities referred to as Treasuries.

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Digital Cash, Real Consequences: Combatting Fraud & Securing the Gift Card Economy

Trade

As retailers, law enforcement, and consumers continue adapting to increasingly sophisticated gift card fraud schemes, Congress faces decisions about whether existing frameworks adequately address the scale and structure of modern retail crime.

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Financing Stability: International Financial Institutions and Advancing U.S. Interests Abroad

Trade

International Financial Institutions (IFIs) can be tools for supporting global development goals and expanding trade opportunities, but their future funding is uncertain.

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Navigating a National Patchwork: State-Level AI Regulations

Governance Technology

As artificial intelligence integrates deeper into the economy, crafting a federal regulatory framework as fast as technology advances has proven challenging. As states advance regulations on their own, developers and businesses using AI are navigating an increasingly complex web of rules and guidelines.

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